Evidence-Based Practice EBP 3601 review, 2 to 3 minutes
A Question From a Shift That Went Wrong
The idea
The technique: turn a clinical irritation into a question a database can answer, starting from the outcome data that provoked it, deciding whether it is background or foreground, and building it in PICOT format so every element names something a search can match.
In practice
A nurse notices three hospital-acquired pressure injuries on the unit in one month, where the previous quarter had one. The irritation is real and the question is not yet askable. Step zero is the spirit of inquiry, and the noticing is where the work begins. Internal evidence comes first: the unit's own incidence data, which set the expectation that something has changed. The question is foreground rather than background, because this clinician knows what a pressure injury is and needs a comparison between two courses of action. Population: adult medical-surgical inpatients at risk of pressure injury. Intervention: repositioning on a documented two-hourly schedule. Comparison: repositioning at nursing discretion. Outcome: incidence of hospital-acquired pressure injury. Time: across ninety days. Read back, it is one sentence, and each element names something a database can match. The type is an intervention question, which sets the designs worth looking for. What the question does not contain is the project — who would run it, what it would cost, whether the unit would adopt it. Those follow the answer, and putting them in front of it narrows the search before it starts.
Where people slip
The temptation is to write the question you intend to answer rather than the one the data provoked, and a question with its intervention already chosen searches for confirmation. Note also that the outcome names a measurable rate rather than better skin care. An outcome a database cannot match is an outcome the search will not find.
Your place on the trail
Every lesson rests on earlier ones and opens later ones. Tap any to jump.
Builds on
- 0010Step Zero — A Spirit of Inquiry
- 0011Step One — Ask in PICOT Format
- 0151Questions Come From Inquiry
- 0152Outcome Data Start the Question
- 0153Data Set the Expectation
- 0159Two Kinds of Clinical Question
- 0160The Background Question
- 0161The Foreground Question
- 0164PICOT
- 0167P — Population
- 0168I — Intervention or Issue of Interest
- 0169C — Comparison of Interest
- 0170O — Outcome
- 0171T — Time
- 0172Not Every Question Needs Every Element
- 0174Five Types of Clinical Question
- 0175Intervention Questions
- 0181Too Few Words, Too Many Words
- 0183A Clinical Question Has No Direction
- 0186Getting the Type Right Early
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